How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,513.56 Median $3,890.45 Typical High $3,890.45 | Facility | None | $1,513.56 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $40.74 Typical High $53.70 | Professional | None | $36.31 | $40.74 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
HMSA Setting Professional Modifier None Typical Low $50.12 Median $58.88 Typical High $64.57 | Professional | None | $50.12 | $58.88 | $64.57 |
HMSA Setting Professional Modifier 51 · Multiple procedures Typical Low $25.12 Median $29.51 Typical High $32.36 | Professional | 51 · Multiple procedures | $25.12 | $29.51 | $32.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33.88 Median $40.74 Typical High $51.29 | Professional | None | $33.88 | $40.74 | $51.29 |
United Setting Facility Modifier None Typical Low $269.15 Median $616.60 Typical High $1,122.02 | Facility | None | $269.15 | $616.60 | $1,122.02 |
United Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $48.98 | Professional | None | $47.86 | $47.86 | $48.98 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $47.86 Typical High $53.70 | Professional | None | $29.51 | $47.86 | $53.70 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $19.95 Typical High $30.90 | Professional | 52 · Reduced service | $18.20 | $19.95 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $8.13 Typical High $12.30 | Professional | 53 · Discontinued | $7.24 | $8.13 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $30.20 Typical High $46.77 | Professional | 54 · Surgery only | $27.54 | $30.20 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.03 Typical High $9.33 | Professional | 55 · Aftercare only | $5.50 | $6.03 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.07 Typical High $6.17 | Professional | 56 · Pre-op care only | $3.63 | $4.07 | $6.17 |
Where Hawaii sits
The same service costs 4.5 times more in Alaska than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Hawaii· 32nd of 51
$50.12
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.